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General NPI Number Information
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NPI Number | 1780061648
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Entity Type | Individual
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Provider Name | JULIE GRIGSBY
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Gender | Female
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Dates
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Enumeration Date | 04/29/2015
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Last Update Date | 04/29/2015
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Provider Practice Location Address
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Address Line | 1500 LEESTOWN RD STE 338
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City | LEXINGTON
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State | KY
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Zip | 40511-2047
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Country | US
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Telephone | 859-317-8295
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 BELLA DONA RD
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City | LEXINGTON
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State | KY
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Zip | 40515-6476
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Country | US
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Telephone | 859-421-7932
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | KY-4162
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License Number State | KY
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